Quick answer: A root canal is usually needed when the pulp inside a tooth has become inflamed or infected. Typical signs are lingering pain after hot or cold, pain on biting, a tooth that darkens, or swelling and tenderness in the gum nearby. The treatment removes the infected pulp and saves a tooth that would otherwise have to be extracted.
What is inside a tooth
Beneath the enamel and dentine, every tooth contains a chamber of soft tissue called the pulp: nerves, blood vessels and connective tissue. Once a tooth is fully developed the pulp is no longer essential to keeping it functional, but while it is alive it is what makes a tooth feel hot, cold and pressure.
When bacteria reach the pulp — through deep decay, a crack, repeated dental work on the same tooth, or trauma — it becomes inflamed and then infected. Because the pulp is sealed inside a rigid chamber, the swelling has nowhere to go, which is why the pain can be severe.
Symptoms that suggest a root canal is needed
- Pain that lingers after hot or cold. Brief sensitivity that disappears in seconds is usually not pulp damage. Pain that continues for 30 seconds or more after the stimulus is removed often is.
- Pain on biting or pressure on one specific tooth.
- Spontaneous pain, particularly pain that wakes you at night.
- A tooth that has darkened compared with its neighbours.
- A tender or swollen gum near a particular tooth, sometimes with a small pimple-like spot that drains.
- No symptoms at all. Some infected nerves die quietly and are found on a routine X-ray.
What the treatment involves
The tooth is numbed, isolated, and an access opening is made. The infected pulp is removed, the canals inside the roots are cleaned and shaped, and they are then filled and sealed. In most cases the tooth is subsequently restored with a crown, because a tooth that has had a root canal is more brittle and needs protecting from fracture.
Treatment may be completed in one visit or across two, depending on the tooth, the number of canals and whether there is active infection to settle first.
Does it hurt?
The reputation is worse than the reality. The severe pain patients associate with root canals is the pain of the infection, not the treatment — and the treatment is what relieves it. With modern anaesthesia the procedure itself is comparable to having a large filling placed. Mild tenderness for a few days afterwards is normal.
The alternative
The alternative to a root canal is usually extraction. That is a legitimate choice in some situations, but it creates a new problem: the gap then needs a bridge, an implant, or accepting the space and the drifting of neighbouring teeth that tends to follow. Saving the natural tooth is generally the simpler and more economical route where it is possible.
Do not wait it out
Toothache that stops on its own is not necessarily good news — it can mean the nerve has died, while the infection continues below. If a tooth has hurt, call (860) 756-5423 even if it has settled.
Frequently asked questions
How do I know if I need a root canal?
The common signs are pain that lingers after hot or cold, pain when biting on one particular tooth, spontaneous pain that wakes you, a tooth that darkens, or a tender swelling in the gum nearby. Only an examination and an X-ray can confirm it.
Is a root canal painful?
With modern anaesthesia the procedure feels much like having a large filling placed. The severe pain patients associate with root canals is caused by the infection, and the treatment is what relieves it.
How long does root canal treatment take?
It is usually completed in one or two appointments, depending on which tooth is involved, how many canals it has, and whether active infection needs to settle first.
Will I need a crown after a root canal?
In most cases yes, particularly on back teeth. A tooth that has had its pulp removed becomes more brittle, and a crown protects it against fracture under chewing forces.
What happens if I do not treat an infected tooth?
The infection does not resolve on its own. It can spread into the surrounding bone and soft tissue, cause an abscess, and eventually lead to loss of the tooth. Pain stopping does not mean the infection has stopped.
Book with Connecticut Family Dental Group
Connecticut Family Dental Group is at 88 New Britain Avenue, Rocky Hill, CT 06067. Call (860) 756-5423 or request an appointment. The practice is open Monday through Thursday.
This article is general information for patients and is not a substitute for an examination or individual clinical advice. If something in your mouth is painful, swollen or changing, call the practice.